The One Republican Who Might Stop Paul Ryan From Destroying Health Care

The House of Representatives last week passed draconian cuts to health-care coverage by starting on their right flank, and then pressuring vulnerable swing-district members one by one until they acquired a majority. The Senate is attempting to duplicate the strategy. Senate Majority Leader Mitch McConnell has entrusted the formulation of his chamber’s health-care bill to a 13-member working group that includes his most extreme members, like Ted Cruz and Mike Lee, while excluding those most likely to defect. Republicans who have expressed concern about cutting Medicaid, like Susan Collins, Lisa Murkowski, and Shelly Moore Capito, are locked out, as are Republicans who might lose seats in a midterm wave (Jeff Flake and Dean Heller). Most pointedly, McConnell has frozen out his party’s most vigorous critic of the House plan: Louisiana senator Bill Cassidy.

There is a template for the Republican moderate in the last quarter-century. They mutter nervously about their party’s direction, and offer their public prayers for a bipartisan solution, but ultimately fold under pressure from their leadership (or, less frequently, leave their party altogether, like Jim Jeffords or Arlen Specter, who switched parties). Cassidy is unique in several respects. He does not come from a blue or purple state, and has no electoral motivation to buck the party line, or to posture as a holdout. Before 2017 he did not have any public identity as a moderate. Most important, he has dissented from the Republican line on health care in ways that go well beyond the vague inferences of his colleagues and undercut the foundations of their argument. Cassidy’s dissent has gone much farther than many people realize.

Obamacare’s coverage gains should be expanded, not rolled back. The conservative movement fervently opposes on principle any expansion of the welfare state. It has viewed Trump’s election as a rare chance to eliminate a social benefit that the government has already created, which is why the GOP has been willing to endure severe political pain in order to repeal Obamacare. In particular, Republicans argue that Americans have no right to medical coverage, and that having insurance does not make you any better off.

Cassidy has instead maintained that all Americans ought to have access to medical care. “There’s a widespread recognition that the federal government, Congress, has created the right for every American to have health care,” he said in March.

The Congressional Budget Office is helpful. Republicans have either dismissed or wildly distorted the Congressional Budget Office’s estimates of their plans — indeed, the House did not wait for CBO to analyze the most recent version of its bill before rushing ahead on a vote. When confronted with the agency’s studies, Republicans wave them away as biased and false.

Cassidy instead urges that its conclusions be taken seriously. “You have to have an umpire, even if the umpire occasionally gets it wrong, because otherwise you are only accepting analysis by people with motivations [to] define certain answers, and so I am very reluctant to disregard what the CBO score is.”

The Republican plan actually raises premiums. Republicans have boasted that the House plan reduces premiums. This is only true in one narrow, deeply misleading way. The Republican bill would drive older, sicker patients out of the market by making insurance unaffordable for them. The remaining customer base would be younger and healthier. As a result, they would pay, on average, lower premiums than the customer base pays in the current exchanges, because they would be buying insurance that covers less care.

A paper by Brookings neatly displays how, if you look at what it would cost for a given person to buy a given level of insurance coverage, the GOP plan actually increases premiums by 13 percent:

The right’s approach has centered around making insurance skimpier, and targeting coverage at younger, healthier people who need less care. They market this idea with pleasant-sounding market euphemisms. Cassidy talks about these ideas the way most Americans do: They’re trying to give people terrible insurance. “I realized the way you lower premiums is that you have terrible coverage,” he told the American Hospital Association yesterday. Cassidy added, “The House plan was scored by the Congressional Budget Office as actually raising premiums.” Calling terrible insurance “terrible,” and admitting the Republican plan makes decent coverage more expensive — this is pure heresy.

Cutting taxes means cutting care. Republicans have sequenced health care before tax cuts because they want to repeal Obamacare’s taxes on rich investors. This strategy, insisted on by Paul Ryan, would use Obamacare repeal to grease the skids for lower taxes. Ryan’s health-care plan reduces taxes on the rich by nearly a trillion dollars, a sum that is offset by lower spending on health-care subsidies.

And while Republicans absurdly deny that their plan would take insurance away from anybody, it’s mathematically obvious that cutting health-care subsidies for the poor and middle class by a trillion dollars is going to result in about a trillion dollars less medical care for the poor and middle class.

Cassidy has come out squarely against using health-care reform to finance a tax cut. “I am a critic of the American Health Care Act,” he continued, to applause from the American Hospital Association yesterday. “I think it’s to set up tax reform and all the money used for coverage is instead going to be used to pay down the bill for tax reform.” When Jimmy Kimmel suggested last night, “I can think of a way to pay for it, is don’t give a huge tax cut to millionaires like me, and instead, leave it how it is. That’s my goal,” Cassidy (appearing on the program) replied, “Tell the American people to call their senators and endorse that concept.”

Donald Trump did not simply run on repeal. Republicans in general have made two promises to the American public. They have attacked Obamacare and promised to repeal it, and also promised to replace it with an alternative that would have lower premiums and deductibles. Given that Republicans oppose any method that would finance better insurance that has lower premiums and deductibles, these two promises turn out to be completely incompatible. Most Republicans have chosen to pretend they only promised repeal, and did not promise to replace Obamacare with better insurance.

Cassidy has emphasized the replace aspect over the repeal aspect. When the CBO found in March that the House plan would throw 24 million Americans off their insurance, Cassidy called it a betrayal of Trump’s commitment. “That’s not what President Trump promised,” Cassidy told CNN. “That’s not what Republicans ran on.” In his remarks to the American Hospital Association yesterday, Cassidy explained, “It’s not that [voters] wanted to get rid of Obamacare, they wanted something better,” he said.

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Cassidy is neither a liberal nor an unqualified defender of Obamacare. He has criticized the status quo for its very real shortcomings — a lack of competition in rural markets, insufficient subsidies for modestly affluent customers whose incomes place them above the subsidy cutoff, and a clumsily designed individual mandate. Taken as a whole, though, Cassidy’s remarks point toward a wholly different direction on health care than his party’s leadership has indicated. Cassidy would construct a plan with different goals: fixing Obamacare rather than tearing it down, and prioritizing more coverage over lower taxes for the rich. And his approach would require a very different political coalition than the one constructed by Ryan and McConnell: Cassidy’s ideas would alienate right-wing Republicans and rely in part, perhaps even mostly, on Democrats.

Working on such a plan with Cassidy would present Democrats in Congress with a difficult choice. They would have to compromise at least some of their ideological objectives in order to make a deal with him. They would also have to surrender what is currently shaping up as their most potent attack and their best chance to retake the House in the midterms. (Either the passage of the cruel Republican plan, or the collapse of the exchanges, or both, could well create a Democratic-wave election.)

But for that scenario even to become a possibility, Cassidy will have to stop McConnell’s steamroller. The math at this point is very simple. Republicans hold 52 Senate seats. They need 50 votes (along with a tie-breaking vote by Vice-President Mike Pence) to pass some version of the House health-care plan, which is designed to be enacted through a budget-reconciliation measure that cannot be filibustered. Ryan hopes the Senate will pass some iteration of his plan within “a month or two.” And it will — unless three or more Republican senators oppose it.

The history of the Republican Party over the last generation — starting, roughly, with the Age of Newt — is a history of conservatives grinding the moderate wing into dust. If Cassidy is going to prevail, he will have to hold two or more of his wavering colleagues, and himself, in the face of what is sure to be unrelenting pressure from the White House and the conservative-movement apparatus. The only reason to think he might succeed, where most before him have failed, is that none of Cassidy’s predecessors have contradicted the party line so baldly and boldly.

As we anticipate the end of Mueller, signs of a wind-down:-SCO prosecutors bringing family into the office for visits-Staff carrying out boxes-Manafort sentenced, top prosecutor leaving-office of 16 attys down to 10-DC US Atty stepping up in cases-grand jury not seen in 2mo

For Boeing and other aircraft manufacturers, the practice of charging to upgrade a standard plane can be lucrative. Top airlines around the world must pay handsomely to have the jets they order fitted with customized add-ons.

Sometimes these optional features involve aesthetics or comfort, like premium seating, fancy lighting or extra bathrooms. But other features involve communication, navigation or safety systems, and are more fundamental to the plane’s operations.

Many airlines, especially low-cost carriers like Indonesia’s Lion Air, have opted not to buy them — and regulators don’t require them. Now, in the wake of the two deadly crashes involving the same jet model, Boeing will make one of those safety features standard as part of a fix to get the planes in the air again.

… Boeing’s optional safety features, in part, could have helped the pilots detect any erroneous readings. One of the optional upgrades, the angle of attack indicator, displays the readings of the two sensors. The other, called a disagree light, is activated if those sensors are at odds with one another.

Boeing will soon update the MCAS software, and will also make the disagree light standard on all new 737 Max planes, according to a person familiar with the changes, who spoke on condition of anonymity because they have not been made public. The angle of attack indicator will remain an option that airlines can buy.

Attorneys for New England Patriots owner Robert Kraft and more than a dozen other defendants charged in a Florida prostitution sting filed a motion to stop the public release of surveillance videos and other evidence taken by police.

Attorneys filed the motion Wednesday in Palm Beach County court. The State of Florida does not agree with the request, according to the filing.

In the motion, the attorneys asked the court to grant a protective order to safeguard the confidentiality of the materials seized from the Orchids of Asia Day Spa in Jupiter, and “in particular the videos, until further order of the court.”

Two years in, White House aides are dismayed to discover the president likes lobbing pointless, nasty attacks at people like George Conway and John McCain

But the saga has left even White House aides accustomed to a president who bucks convention feeling uncomfortable. While the controversies may have pushed aside some bad news, they also trampled on Trump’s Wednesday visit to an army tank manufacturing plant in swing state Ohio.

“For the most part, most people internally don’t want to touch this with a 10-foot pole,” said one former senior White House official. A current senior White House official said White House aides are making an effort “not to discuss it in polite company.” Another current White House official bemoaned the tawdry distraction. “It does not appear to be a great use of our time to talk about George Conway or dead John McCain. … Why are we doing this?

When Mr. Trump was running for president, he promised to personally stop American companies from shutting down factories and moving plants abroad, warning that he would punish them with public backlash and higher taxes. Many companies scrambled to respond to his Twitter attacks, announcing jobs and investments in the United States — several of which never materialized.

But despite Mr. Trump’s efforts to compel companies to build and hire, they appear to be increasingly prioritizing their balance sheets over political backlash.

“I don’t think there’s as much fear,” said Gene Grabowski, who specializes in crisis communications for the public relations firm Kglobal. “At first it was a shock to the system, but now we’ve all adjusted. We take it in stride, and I think that’s what the business community is doing.”

There’s no specific stipulation that Milo must be heard, so it could be worse

President Trump is expected to issue an executive order Thursday directing federal agencies to tie research and education grants made to colleges and universities to more aggressive enforcement of the First Amendment, according to a draft of the order viewed by The Wall Street Journal.

The order instructs agencies including the Departments of Education, Health and Human Services and Defense to ensure that public educational institutions comply with the First Amendment, and that private institutions live up to their own stated free-speech standards.

The order falls short of what some university officials feared would be more sweeping or specific measures; it doesn’t prescribe any specific penalty that would result in schools losing research or other education grants as a result of specific policies.

Tech companies say that it is easier to identify content related to known foreign terrorist organizations such as ISIS and Al Qaeda because of information-sharing with law enforcement and industry-wide efforts, such as the Global Internet Forum to Counter Terrorism, a group formed by YouTube, Facebook, Microsoft, and Twitter in 2017.

On Monday, for example, YouTube said on its Twitter account that it was harder for the company to stop the video of the shootings in Christchurch than to remove copyrighted content or ISIS-related content because YouTube’s tools for content moderation rely on “reference files to work effectively.” Movie studios and record labels provide reference files in advance and, “many violent extremist groups, like ISIS, use common footage and imagery,” YouTube wrote.

The cycle is self-reinforcing: The companies collect more data on what ISIS content looks like based on law enforcement’s myopic and under-inclusive views, and then this skewed data is fed to surveillance systems, Bloch-Wehba says. Meanwhile, consumers don’t have enough visibility in the process to know whether these tools are proportionate to the threat, whether they filter too much content, or whether they discriminate against certain groups, she says.

Two mystery litigants citing privacy concerns are making a last-ditch bid to keep secret some details in a lawsuit stemming from wealthy financier Jeffrey Epstein’s history of paying underage girls for sex.

Just prior to a court-imposed deadline Tuesday, two anonymous individuals surfaced to object to the unsealing of a key lower-court ruling in the case, as well as various submissions by the parties.

Both people filed their complaints in the New York-based 2nd Circuit Court of Appeals, which is overseeing the case. The two people said they could face unwarranted speculation and embarrassment if the court makes public records from the suit, in which Virginia Giuffre, an alleged Epstein victim, accused longtime Epstein friend Ghislaine Maxwell of engaging in sex trafficking by facilitating his sexual encounters with teenage girls. Maxwell has denied the charges.

Rescue teams in Mozambique are struggling to reach the thousands of people stranded on roofs and in trees and urgently need more helicopters and boats as post-cyclone flood waters continue to rise.

Rescue workers, military personnel and volunteers are rushing to save thousands of Mozambicans before flood levels rise further, but with four helicopters, a handful of boats and extremely difficult conditions, have only been able to save about 413 so far.

“I don’t even know if we’ve made a dent. There are just so many people. The scale is huge. We’re busy doing the best we can,” said Travis Trower from Rescue South Africa, adding that a lot of people had been washed away but those still alive, whom he had seen from helicopter flights, were in a very bad state.

More than 400 sq kilometres (150 sq miles) in the region are flooded, according to satellite images taken by the EU, and in some places the water is six metres (19ft) deep. At least 600,000 people are affected, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA), ranging from those whose lives are in immediate danger to those who need other kinds of aid.

About 40 percent of the District’s lower-income neighborhoods experienced gentrification between 2000 and 2013, giving the city the greatest “intensity of gentrification” of any in the country, according to a studyreleased Tuesday by the National Community Reinvestment Coalition.

The District also saw the most African American residents — more than 20,000 — displaced from their neighborhoods during that time, mostly by affluent, white newcomers, researchers said. The District and Philadelphia were most “notable” for displacements of black residents, while Denver and Austin had the most Hispanic residents move. Nationwide, nearly 111,000 African Americans and more than 24,000 Hispanics moved out of gentrifying neighborhoods, the study found.

In an essay accompanying the study, Sabiyha Prince of Empower DC said the city “rolled out the proverbial red carpet” for tens of thousands of new residents in the past five years. But the new dog parks, bike lanes, condominiums and pricey restaurants that followed, she said, are not viewed as improvements by long-term residents, who can feel isolated because of losing neighbors, social networks and local businesses. Prince, an anthropologist, said longtime Washingtonians tell stories of “alienation and vulnerability in the nation’s capital.”